Gateway to heroin is often legally prescribed drugs

By many accounts, the gateway to heroin addiction is not through other illicit drugs like cocaine or marijuana, but through prescription opiates like Oxycontin or Percocet. As such, one of the biggest ways to combat heroin addiction is to monitor or curtail the prescription of such powerful painkillers.

“The problem here in Pennsylvania is that there is nothing a physician can tap into to see if (addicts are) shopping. Legally, we do not have access to that information,” said Dr. Greg Pierce, a doctor at the methadone clinic, Habit OPCO in Pottstown. “That would be huge to helping this war against opiate use.”

Douglas Albertson, the clinic’s director, said a system like the one Pierce references exists in Ohio and other states in the Midwest.

Habit OPCO has all of its patients dual-enroll with other methadone clinics so that they can track whether their patients have been seeking treatment elsewhere and attempting to “double-dip.”

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But Albertson and Pierce are unable to check up with physicians unless their patients give permission.

“I don’t know where you’ve been,” Pierce said. “You could have seen 10 physicians that have prescribed opiates.”

“We’d have to get a release from every physician within a 50-mile radius of this building,” Albertson said. “That’s how determined addicts can be.”

The director of Temple University School of Medicine’s Center for Substance Abuse Research said addiction to prescribed pain medication has grown markedly in recent years.

Special law enforcement units have helped educate and cut down on overprescription of opiates in recent years, according to Lower Frederick Police Chief Paul Maxey, but issues do persist.

“The majority of doctors are ethical, legitimate doctors,” Maxey said. “But there are doctors that will write these scripts for profit.”

Albertson and Pierce said they have dealt with certain unscrupulous doctors.

“One of our patients said they went into the doctor’s office and had a prescription written out for them (for a painkiller) before they even told them what was wrong,” Albertson said.

Ethical doctors that are not pushing prescriptions for their own financial benefit can also be duped into feeding an addict’s problems, according to Albertson and Pierce.

“Addicts are some of the smartest people I know,” Albertson said.

“Once you let them know that you have the power to get them what they want, they know they’ve got you,” Pierce said. “It’s not hard for a patient to go into a doctor’s office and recite the symptomology (of something requiring a painkiller) and present them and the doctor would go, ‘Oh my gosh, okay, fine.’”

Coleen Watchorn, whose son Stephen died in August of an overdose after moving from prescription pills to heroin, says parents don’t question doctors enough about the number of presriptions they give out. As a parent, you tell your child to take his medicine, and you don’t know it may be too much, she said.

Then there’s the manipulation once a person becomes addicted. “How many times can an addict say to a doctor, ‘I lost my prescription,’ before the doctor says, ‘No you can’t have any more,’?” she said.

Guarding against overprescription

The education of doctors into the manipulation by addicts could be paramount to cutting down on opiate addiction that could later lead to heroin.

Although only a small number of people get addicted to painkillers when they’re properly prescribed and used, many of the problems arise when those prescriptions are shared with family or friends.

Pierce said workers could end up abusing painkillers and sharing them with colleagues just to get themselves through a physically taxing day. He said he’s heard of Percocet being nicknamed “Work-ocet.”

Some pharmacists are now using online databases with the encouragement of police to track prescriptions, a system that is helping, said Limerick Detective Matt Daywalt.

Area police have participated in the annual National Drug Take Back Program, sponsored by the U.S. Drug Enforcement Administration, which provides residents the opportunity to safely rid their homes of expired and unused prescription painkillers before they get in the hands of abusers.

Unterwald said research is also being done into the effects painkillers have when prescribed to younger children for issues like broken bones or other injuries.

To date, she said, there hasn’t been much proof of a link between childhood prescription of opiates and later-life addiction to painkillers or heroin.

However, some of the behaviors that may have led to the injuries that require the painkillers might be indicators of a personality prone to such an addiction.

“Maybe you have a kid who is a risk taker,” Unterwald said. “It’s very well-documented that kids who are risk-takers are more likely to be involved in substance abuse.”

Albertson said he and the clinic he manages are doing everything they can to keep on the lookout for prescription abuse, striving to keep lines of communication open with local law enforcement and pharmacies.